Focused transesophageal echocardiography (TEE) is now recommended during cardiac arrest in the emergency department. TEE training has not been traditionally present during emergency medicine training thus a comprehensive implementation science approach is necessary to address the barriers and promote the facilitators towards this application.
Targeted training is necessary to maximize learning retention and decrease skill decay. Pragmatic application of an integrated approach for TEE training including simulation facilitates acquisition of skills and knowledge. We are using implementation science approach in two broad categories: to increase the adoption of rTEE during cardiac arrest and to protocolize the interventions based on rTEE in order to improve CPR quality and increase likelihood of ROSC during cardiac arrest.
We know that resuscitative TEE can provide diagnostic and potentially therapeutic value to physicians during cardiac resuscitation. Our research focus is to 1) develop a protocolized algorithm of how and where to incorporate the 3 TEE views into the ACLS algorithm; 2) develop standardized criteria of “high quality” CPR, such as aortic valve opening and LV wall movement, with the overarching goal to individualize chest compressions; and 3) define markers of poor CPR quality, like non-ventricular compression or LVOT obstruction.
- W. Huang, E. Blustein, A. Croft, V. Lew, D. Theodoro, E. Ablordeppey, 298 Proficiency-Based Simulation Training: Will This Work for Resuscitative Transesophageal Echocardiography?, Annals of Emergency Medicine, Volume 82, Issue 4, Supplement, 2023, Page S131, ISSN 0196-0644, https://doi.org/10.1016/j.annemergmed.2023.08.322.
- E. Ablordeppey, L. Wallace, C. Murray, D. Theodoro, 186 Low Frequency, High Complexity: Skill Retention Following Proficiency-Based Transesophageal Echocardiography Simulation Training, Annals of Emergency Medicine, Volume 78, Issue 4, Supplement, 2021, Pages S74-S75, ISSN 0196-0644, https://doi.org/10.1016/j.annemergmed.2021.09.197.